AI Summary Overview
What are Warts?
Warts are benign growths that may develop on the skin and mucosa membranes (like inside your mouth). They are usually caused by certain human papillomaviruses (HPV) and can appear on the feet, hands, face, genitals and other parts of the body. Most warts are harmless, but can sometimes be painful.
Although there are more than 100 different types of HPV, only some can cause warts in specific parts of your body.
What are the Types of Warts?
Warts can be classified based on their appearance. The common types of warts are listed below:
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Common Warts (Verruca Vulgaris) Common warts develop on the hands and appear as rough, raised bumps. They may consist of black dots, which are clotted and dead capillaries. They can range from pinhead size to pea size. The causes of common warts are HPV types 2 and 4, along with types 1, 3, 7, 27, 29 and 57.
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Plantar Warts Plantar warts develop on the soles of the feet. They may appear raised or flat and grow inward and may contain black dots. Larger plantar warts may become painful, especially when walking or standing. HPV types 1, 2, 4, 27 and 57 cause plantar warts.
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Mosaic Warts Mosaic warts are small warts that usually develop on the balls of the feet or under the toes. They can spread and cover larger areas of the foot. Unlike plantar warts, mosaic warts may appear flattened and can cause pain while walking. HPV type 2 causes mosaic warts.
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Flat Warts Flat warts are smoother and smaller than common warts and may occur on hands, face, legs or arms. They occur in larger numbers, ranging from 20 to 100 warts at a time. HPV types 3, 10 and 28 cause flat warts.
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Filiform Warts Filiform warts appear as thin and thread-like growths and are found around the nose, mouth, eyes and other parts of the face. HPV types 1, 2, 4, 27 and 29 can cause filiform warts.
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Genital Warts Genital warts occur in the genital or anal region and can spread through skin-to-skin sexual contact. They are considered a sexually transmitted infection (STI) and may appear as small, firm nodules with rough surfaces. HPV types 6 and 11 cause about 90% of genital warts.
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Butcher's Warts Butcher's warts may develop on the hands of people who handle raw meat, including butchers. They are associated with occupations involving frequent exposure to cold, moist environments. HPV type 7 causes butcher warts.
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Focal Epithelial Hyperplasia (Heck's Disease) Focal epithelial hyperplasia is called Heck's disease. It is a rare condition in which warts may occur inside the mouth on the mucosal surfaces. HPV types 13 and 32 may cause this wart condition.
How Common are Warts in India?
Warts commonly occur in India among people of all ages. A study estimated the prevalence of genital warts in India to be 1.07%, with regional prevalence ranging from 0.04% in Bangalore to 2.17% in Delhi.
Non-genital warts are common in teenagers and children aged 5 to 20 years of age because they are often in contact with people at school, are active in play and have immature immune systems. Genital warts are more common later in life, especially in those aged 25 to 29.
What are the Symptoms of Warts?
Warts' appearance may vary depending on their type and where they occur. Some warts can be painless, while others are known to cause discomfort.
Here are the early warning and advanced symptoms of warts:
| Early Symptoms | Advanced Symptoms |
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Diseases Similar to Warts
Warts may look similar to other skin problems, and make it hard to diagnose without medical examination. Doctors may identify these diseases by comparing their causes, locations and symptoms.
The table below provides a comparative overview of three such conditions to help understand the distinct features:
Warts Vs. Corns Vs. Molluscum Contagiosum
| Feature | Warts | Corns | Molluscum Contagiosum |
| How It Happens | Caused by the types of human papillomavirus (HPV). | Develop due to repeated pressure or friction on the skin. | Caused by the molluscum contagiosum virus. |
| Location | Hands, feet, face and other areas. Genital warts affect the genital area. | Feet, toes, or other pressure-bearing areas. | Face, trunk, arms and other areas of the skin. |
| Associated Symptoms | Rough or firm growths that may become painful, particularly on the feet. | Thickened, hardened skin that can become painful or tender. | Small, firm, often painless raised bumps with a central depression. |
| Severity | Harmless. May spread, persist and be painful. | Not serious. Walking or standing may cause discomfort. | Mild. Symptoms may disappear without treatment. |
| Can It Be Reversed? | May disappear naturally. Recurrent warts may require treatment. | Improvement with reduction of pressure. | Clears naturally, but some cases may require treatment. |
What Causes Warts?
Warts may occur due to human papillomavirus (HPV), which enters the body through weak areas or small breaks in the skin. Once a virus enters skin cells, it may lead to rough and thick growth characteristics of a wart. Below are the common causes of warts:
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Virus: HPV may enter the skin through tiny cuts, scrapes or other weak spots that may not be visible.
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Cell Growth: Once inside, the virus can cause the increased production of keratin, a hard protein found in the outer layer of the skin.
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Thickened Skin: The increased cell and keratin production may make the outer skin layer thicker and rougher. It may form the raised bump recognised as a wart.
What are the Risk Factors for Warts?
Some factors may increase the risk of warts, including age, weakened immune system, damaged skin and behaviours or environments that increase exposure to human papillomavirus (HPV). Below are the risk factors associated with warts:
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Personal and Biological Factors
- Age: The age of a person may impact the risk of warts. It mainly occurs in young adults and children because of their lesser resistance of immune systems to HPV.
- Weakened Immune System: Those who have a weakened immune system, such as people taking immunosuppressant medicines, may experience a high risk of warts.
- Skin Damage: Scrapes, cuts, hangnails, or damaged skin make it easier for HPV to enter the body.
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Behavioural and Environmental Factors
- Nail Biting and Picking: Picking hangnails or biting nails creates small breaks in the skin, and allows HPV to spread the warts.
- Public Wet Areas: Walking barefoot in swimming pools, communal showers, and locker rooms can increase the exposure to HPV that causes plantar warts.
- Shared Personal Items: Sharing washcloths, towels, socks, razors or other personal items with someone who has warts may increase viral spread.
- Frequent Wet Work: Repeated water exposure may soften your skin and weaken its protective barrier. It may make your skin more vulnerable to infection.
- Occupational Exposure: People who handle raw meat, poultry, or fish frequently may experience high risks of butcher warts. Risks may increase when their hands are exposed to moisture or minor skin injuries.
- Sexual Activity: Sexual skin-to-skin contact is another risk factor for genital warts. Having multiple sexual partners and unprotected sex can increase the risk of HPV exposure.
What are the Complications of Warts?
Most warts may disappear without significant problems. Complications that may be caused by warts can include:
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Infection: Infections may occur if you cut or pick the wart. Breaks in your skin can allow bacteria to enter.
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Pain: Most warts do not cause pain. But plantar warts grow inward into the foot and become painful while walking. You may feel as though there is a pebble under the skin.
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Mental Health Impact: Having warts may affect your self-esteem and mental health.
When Should I See a Healthcare Provider?
If over-the-counter treatment has not helped to treat your warts, you may need prompt doctor attention. See a doctor if:
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A growth that may not be a wart or looks suspicious
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Warts on the face, genitals or rectum, or inside the mouth
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Multiple warts
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Warts causing itching, burning or bleeding
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Weakened immune system
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You have diabetes and develop a wart or similar growth on your foot
How are Warts Diagnosed?
Doctors diagnose warts by examining their appearance, location and texture on the skin. Additional testing may be required to rule out other skin conditions or identify the unusual growth.
The following tests and assessments may be conducted by doctors to diagnose warts:
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Physical Examination Doctors may diagnose warts by examining their appearance, location and texture.
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Skin Examination With Magnification A doctor can use magnification to examine the surface features. This helps to distinguish a wart from other skin growths.
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Skin Biopsy A skin biopsy may be used when the wart's appearance is unusual, the growth fails to respond to treatment or diagnosis is uncertain. During assessment, a small piece of tissue is tested in the lab.
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Tests for Genital Warts Genital warts are diagnosed by physical examination. HPV testing is not routinely used in the diagnosis of genital warts. HPV tests have specific applications in cervical cancer screening.
Diagnostic Summary Table
| Test | What it Helps Assess | Typical Purpose |
| Physical examination | Location, appearance and texture of the wart | Most common warts |
| Dermatoscopy | Characteristics of the skin growth | Unusual or difficult warts |
| Skin biopsy | Changes in skin tissue under a microscope | Growths that look unusual, bleed, grow rapidly, or do not respond to treatment. |
| Genital examination | Characteristics and appearance of genital lesions | Suspected genital warts |
| HPV testing | High-risk HPV types | Cervical cancer screening, not routine diagnosis of ordinary warts |
How are Warts Treated and Managed?
Some warts disappear on their own, while some warts may take up to two years to disappear. Treatment may be considered when warts spread, cause pain or affect your daily activities. The right treatment method depends on the type, persistence and location of the wart.
Treatment and management methods of warts are as follows:
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Over-the-Counter Treatments Over-the-counter wart removal products commonly contain salicylic acid, which gradually dissolves the wart layer by layer. These products are available as liquids, gels and patches. Daily application may be required for several months.
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Medical Topical Treatments A healthcare provider may apply cantharidin to the wart. This treatment causes a blister to form underneath the wart, helping separate it from the skin. The dead wart is usually removed during a follow-up visit about a week later.
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Cryotherapy In cryotherapy, doctors may apply liquid nitrogen to the affected area to freeze the wart. It can peel away the tissue and separate the warts from your skin. Doctors may also recommend several treatment sessions to achieve wart clearance.
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Other Wart Treatments
Some other treatments may also be considered to treat warts. They include:
- Immunotherapy: Immunotherapy may be used to treat persistent warts.
- Surgical Removal: Surgeries may be performed to cut the wart. This method may cause scarring.
- Electrosurgery: In electrosurgery, doctors may use a specially designed heated needle to burn away the wart tissue.
- Laser Treatment: Laser treatment may be considered to heat and destroy the small blood vessels supplying the wart. This treatment method may cause scarring.
Common Medicines Used to Treat Warts
The medicines used for the treatment of warts may vary depending on their types and where they are located. Common medicines used to treat warts are:
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Salicylic Acid: It helps to slowly remove the layers of common warts, plantar warts and flat warts.
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Topical Medicines: Some prescribed topical medicines can be used for persistent or genital warts.
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Immune Modifying Therapies: Immune-modifying therapies may be considered in cases of certain persistent warts.
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Other Topical Treatments: A doctor may consider stronger chemical treatments if the usual methods fail.
Note: Do not use any medicine on genital warts without professional advice. The right medicine choice should be based on the location and type of wart.
Living With Warts: Daily Challenges and Caregiving
Living with warts can be frustrating and emotionally draining. Warts may be harmless, but they are highly contagious and hard to eliminate.
Some of the challenges and care points for people with warts are mentioned below:
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Over-the-Counter Treatments Over-the-counter wart removal products commonly contain salicylic acid, which gradually dissolves the wart layer by layer. These products are available as liquids, gels and patches. Daily application may be required for several months.
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Medical Topical Treatments A healthcare provider may apply cantharidin to the wart. This treatment causes a blister to form underneath the wart, helping separate it from the skin. The dead wart is usually removed during a follow-up visit about a week later.
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Cryotherapy In cryotherapy, doctors may apply liquid nitrogen to the affected area to freeze the wart. It can peel away the tissue and separate the warts from your skin. Doctors may also recommend several treatment sessions to achieve wart clearance.
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Other Wart Treatments
Some other treatments may also be considered to treat warts. They include:
- Immunotherapy: Immunotherapy may be used to treat persistent warts.
- Surgical Removal: Surgeries may be performed to cut the wart. This method may cause scarring.
- Electrosurgery: In electrosurgery, doctors may use a specially designed heated needle to burn away the wart tissue.
- Laser Treatment: Laser treatment may be considered to heat and destroy the small blood vessels supplying the wart. This treatment method may cause scarring.
What is the Prognosis for Warts?
The prognosis for warts is usually favourable. Around two-thirds of warts resolve naturally over several years. This makes it difficult to determine the effectiveness of individual treatments. Warts that disappear on their own usually do not leave residual scarring.
However, treatment does not always lead to successful clearance. Treatment failures are common and may result in pain and significant cosmetic concerns. Besides, most of the topical treatments may cause moderate to severe scarring.
Malignant transformation of common warts is rare. In uncommon cases, a wart may transform into verrucous carcinoma, which mostly occurs on the plantar surface.
How Can I Prevent Warts?
There is no guaranteed way to prevent warts. But you can reduce the risks of acquiring HPV that causes them. Below are some prevention steps to take to reduce the chances of getting warts:
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Avoid touching another person's warts.
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Avoid sharing towels, washcloths, nail clippers, clothing, razors, or other personal items.
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Avoid biting your nails or picking at cuticles.
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Keep your skin moisturised and protect cuts. HPV can easily enter broken or cracked skin.
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Discuss the HPV vaccine with your doctor and use condoms to prevent genital warts.
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Wear flip-flops or shoes while using the public pools, areas, showers, or the locker room.
If you already have warts, below are some prevention measures to avoid spreading them:
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Cover the wart with a bandage.
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Do not scratch, cut or pick at it.
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Wash your hands immediately after you touch warts.
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Avoid shaving over the wart.
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Keep feet dry to prevent the spread of plantar warts.
Warts Treatment Cost in India
Warts treatment costs in India depend on the number of warts, location, number of sessions, treatment method and healthcare facility.
An estimate of warts treatment costs in India is given in the table below:
| Treatment type | Approximate cost range (INR) |
| Topical salicylic acid/ OTC wart paints | ₹30 - ₹250 per bottle (10 - 30 ml) |
| Topical prescription creams (e.g., imiquimod 5%) | ₹180 - ₹460 per pack (0.25 g sachets or small tube) |
| Cryotherapy (liquid nitrogen) | ₹500 - ₹2,000 per wart per session |
| Electrocautery/ radiofrequency (RF) | ₹1,000 - ₹5,000 per wart |
| CO₂ laser wart removal | ₹1,500 - ₹8,000 per wart per session |
| Laser vaginal/genital wart treatment | ₹10,000 - ₹25,000 |
| LEEP/ surgical excision (genital warts) | ₹20,000 - ₹30,000 |
| Surgical excision (non-genital warts) | ₹5,000 - ₹20,000 |
Note: The above prices are indicative. Actual costs may be higher or lower depending on the hospital, location and treatment required. For more accurate estimates, contact a hospital representative.
Does Health Insurance Cover Warts in India?
Yes. Health insurance covers the treatment of warts in India. It may cover wart removal if it is medically necessary and pay for or reimburse wart treatment costs if the growth causes clear physical complications. Coverage may include in-patient hospitalisation costs, surgery costs and pre- and post-hospitalisation expenses. Coverage may range from one policy to another.
However, surgery or treatment of warts for cosmetic reasons is usually not covered. Besides, diagnostic test charges, doctor consultation fees and cost of medicines may be covered with the OPD benefit.
The waiting period may apply before the policy can be claimed for warts treatment. Therefore, review exclusions, waiting periods, co-payments, room-rent restrictions, sub-limits and outpatient coverage before purchasing a policy.
How Much Health Insurance Coverage is Needed for Warts Treatment?
Most warts may not require hospitalisation or prolonged treatment. Persistent, painful, or multiple warts may require several consultations or procedures. The estimated costs range between ₹5,000 and ₹15,000 per session. The exact costs may vary depending on healthcare facilities.
Hence, a medical coverage of around ₹5 - ₹10 lakh is usually recommended for general healthcare needs resulting from warts treatments. A higher coverage of ₹10 - ₹15 lakh may be considered for better protection against major hospitalisation, such as warts removal procedure.
Frequently Asked Questions (FAQs)
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Q1. Can warts disappear on their own?
Ans: Yes, around 65% of warts disappear on their own within two years. This usually happens with people who have healthy immune systems. Warts may not disappear on their own if someone is immunocompromised. -
Q2. Are warts harmful?
Ans: Most warts are benign. But they can become harmful when they impact your self-esteem or affect your everyday things like wearing shoes or walking. -
Q3. Are warts contagious?
Ans: Yes, warts can be contagious because HPV is contagious. It may spread through direct or indirect contact. Direct contact may be defined as touching someone else's wart or having skin-to-skin contact. Indirect contact refers to using objects like razors or towels of a person with a wart or HPV.
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References
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https://www.ncbi.nlm.nih.gov/books/NBK431047/
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https://pubmed.ncbi.nlm.nih.gov/29717924/
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https://www.ckbhospital.com/treatment/genital-warts-treatment-in-delhi
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